Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Nicole Marie Funk, PA-C

Individual provider Physician Assistant · NPI 1669002721

Nicole Marie Funk, PA-C is a Physician Assistant in Meridian, Idaho. Qualified in 2019, 7 years ago. Practices with Orthopaedic Trauma Consultants of Idaho, a 2-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in California and Idaho.

Years since qualifying
7
Licensed in
CA, ID
In the registry since
2020
Specialties on file
3
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

875 S Vanguard Way
Meridian, ID 83642-8540
Phone: (208) 463-3000
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Additional practice locations (1)

  • 215 E Hawaii Ave, Nampa, ID 83686-6011 — (208) 463-3000

Specialties & licences

Surgical Physician Assistant (primary) Taxonomy 363AS0400X · Licence PA-1843 (ID)
Physician Assistant Taxonomy 363A00000X · Licence PA-1843 (CA)
Physician Assistant Taxonomy 363A00000X · Licence PA-1843 (ID)

Record details

NPI number1669002721
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedJanuary 16, 2020
Last updated in NPPESNovember 1, 2023
Certification dateNovember 1, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2019 (7 years in practice)
Group practice Orthopaedic Trauma Consultants Of Idaho — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Meridian